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严重弯曲 H 形根管下颌第一前磨牙的窝洞设计对其折裂行为的影响。

Influence of Cavity Designs on Fracture Behavior of a Mandibular First Premolar with a Severely Curved h-shaped Canal.

机构信息

The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

出版信息

J Endod. 2021 Jun;47(6):1000-1006. doi: 10.1016/j.joen.2021.03.012. Epub 2021 Mar 26.

Abstract

INTRODUCTION

This study aimed to investigate the fracture behavior of a mandibular first premolar with a severely curved h-shaped canal using the extended finite element method.

METHODS

Following the micro-computed tomographic data, models of the intact tooth, the conservative endodontic cavity (CEC), the modified conservative endodontic cavity (MCEC), and the traditional endodontic cavity (TEC) were created. All models were subjected with a total load of 600 N perpendicularly to the contact areas. The distributions of maximum principal stress were recorded. The evolution of cracks in the enamel and dentin was simulated with the extended finite element method.

RESULTS

The intact tooth showed the highest crack initiation load and the smallest stress concentration area. The CEC and MCEC showed higher crack initiation loads and smaller stress concentration areas compared with the TEC. On the occlusal surface, tensile stress was centralized around the distal fossa and the distal margins of cavities. In the root, the stress was concentrated at the mesiolingual side for all models and at the internal surface on the bifurcation section for the CEC. Cracks originated at buccal side of the distal fossa and microcracks were formed confined to the enamel, and then cracks occurred in the dentin below the bone level.

CONCLUSIONS

For the mandibular first premolar with a severely curved h-shaped canal, the MCEC preserved the fracture resistance equally as well as the CEC and reduced the stress concentration on the bifurcation section. The fracture initiated in the enamel, forming microcracks on the buccal side of the distal fossa and then occurred as an irreparable fracture in the dentin.

摘要

简介

本研究旨在使用扩展有限元法研究具有严重 H 形弯曲根管的下颌第一前磨牙的骨折行为。

方法

根据 micro-CT 数据,建立了完整牙、保守牙髓腔(CEC)、改良保守牙髓腔(MCEC)和传统牙髓腔(TEC)的模型。所有模型均垂直于接触区域施加 600 N 的总载荷。记录最大主应力的分布。使用扩展有限元法模拟牙釉质和牙本质中裂纹的演化。

结果

完整牙显示出最高的裂纹起始载荷和最小的应力集中区。CEC 和 MCEC 与 TEC 相比,显示出更高的裂纹起始载荷和更小的应力集中区。在牙合面,拉伸应力集中在远中窝和腔的远中边缘周围。在根部,所有模型的应力都集中在近中舌侧,而 CEC 的分叉部分则集中在内部表面。裂纹起源于远中窝的颊侧,牙釉质内形成微裂纹,然后在骨下的牙本质中发生不可修复的裂纹。

结论

对于具有严重 H 形弯曲根管的下颌第一前磨牙,MCEC 与 CEC 同样保留了抗折能力,并减少了分叉部位的应力集中。骨折始于牙釉质,在远中窝的颊侧形成微裂纹,然后在牙本质中发生不可修复的断裂。

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